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• Complete items 1 ~-~tlor 2 for additional services. <br />• Complete items 3L 1 4a & b. <br />• Print your name a ddress on the reverse of this form so <br />that we can return [his card to you. <br />• Atta>;h this corm to the front of the taailpiece, or on the <br />back if space does not permit. <br />• Write "Return Receipt Requested" on the mailpiece next to <br />to: <br /> <br />yoming Department of Environments <br />?2 West 2~ Street <br />th Floar West Wing <br />heyenne, WYOm11lg 82002 <br />5. Signature (Addressee) <br />6. Signature IAgen[I <br />trV.S. ltPb 1 WD-273661 <br />SL yv, <br />c 80-001 <br />P 179 165 595 <br />o Receipt for <br />Certified Mail <br />C\ ~_ No Insurance Coverage Provided <br />Q KK14Y~~ Do not use for International Mail <br />(,~ ISee Reversel ' <br />C <br />m <br /> <br />N <br />C <br />flf <br />E <br />~- <br />M °i <br />Y ~ <br />~~ <br />'•~ <br />~O <br />1 t•1 <br />Cm <br />+6 0 <br />t LL <br />N <br />a <br />ent to (VjGAi ( p <br />!~ CII. <br />! m~ <br />/.~ <br />$I~eEI an0 NO ~..J~CI ~ ~(~~ <br />.O. I ~ 67 <br />P 0 . Slam and ZIP <br />-a~b~ <br />Postage <br />• <br />Cen~l~etl <br />C <br />s a <br />Soecei D •~ <br />Restnne0 Deis Fee <br />Remm Receiol Snowing <br />io Wnom 6 Date Deine~ea <br />Relmn Pettioi Snowing to Wnom. <br />Daw, antl Atloressee'e AtlO~ess <br />'AL Postage <br />Pos~mark o~ Date <br />I also wish to receive the <br />tollowing~ices (for an extra <br />feel: <br />1. ^ Addressee's Address <br />2. ^ Restricted Delivery <br />~ed ^ Insured <br />f ^ coo <br />Mail ^ Return Receipt for <br />Merchandise <br />Delivery <br />8. Addressee's <br />and tee is p. <br />34 <br />